Beta-Human Chorionic Gonadotropin and Uterine Artery Doppler Measurements for the Prediction of Success of Single Dose Methotrexate Treatment in Tubal Ectopic Pregnancies

Abstract

OBJECTIVES: To evaluate the impact of the uterine artery Doppler values and the change of ?-Humanchorionic gonadotropin (?-HCG) levels from day 0 to day 4 for prediction of the success of single dosemethotrexate treatment in tubal pregnancy cases. STUDY DESIGN: 50 patients with tubal pregnancy were included the prospective study. The locationand size of ectopic pregnancy, bilateral uterine artery pulsed color doppler imaging was examined by ultrasonography and serum ?-HCG levels were measured on day 0, 4, 7 of treatment. Success was defined as decrease of ?-HCG level <10 mIU/mL with single dose methotrexate treatment. Multiple dosemethotrexate treatment and surgical treatment were considered as treatment failure.RESULTS: 32 patients (64%) treated with single dose methotrexate, 14 patients (28%) treated with multiple dose methotrexate, and 4 patients (8%) treated with surgery. In the group with ?-HCG level decrease > 15.04% on day 4, single-dose methotrexate therapy were 3.82 times more successful than thegroup without > 15.04% ?-HCG decrease. However, no significant alteration of uterine artery Dopplermeasurements was determined on the same days.CONCLUSION: Reduction rate in the ?-HCG level on day 4 of treatment can be used in determinationthe success of single-dose methotrexate therapy.